Sawayama Hiroshi, Miyamoto Yuji, Ogawa Katsuhiro, Yoshida Naoya, Baba Hideo
Department of Gastroenterological Surgery Graduate School of Medical Sciences Kumamoto University Honjo Japan.
Ann Gastroenterol Surg. 2020 Jul 21;4(5):528-539. doi: 10.1002/ags3.12362. eCollection 2020 Sep.
The classification of colorectal cancer (CRC) plays a pivotal role in predicting a patient's prognosis and determining treatment strategies. The consensus molecular subtype (CMS) classification system was constructed by analyzing genetic information from 18 CRC data sets, containing 4151 CRC samples. CRC was classified into four subtypes with distinct molecular and biological characteristics: CMS1 (microsatellite instability immune), CMS2 (canonical), CMS3 (metabolic), and CMS4 (mesenchymal). Since their designation in 2015, these classifications have been applied to basic and translational research of CRC, with the hope that understanding these subsets will influence a clinician's approach to therapeutic treatment and improve clinical outcomes. We reviewed CRC investigations in accordance with CMSs published in the last 5 years to further explore the clinical significance of these subtypes and identify underlying trends that may direct relevant future research. We determined that CMSs linked common features of CRC cell lines and PDX models in various studies. Furthermore, associations between prognosis and clinicopathological findings, including pathological grade and the stage of carcinogenesis, tumor budding, and tumor location, were correlated with CMS classification. Novel prognostic factors were identified, and the relationship between chemotherapeutic drug resistance and CMS has been fortified by our compilation of research; thus, indicating that this review provides advanced insight into clinical questions and treatment strategies for CRC.
结直肠癌（CRC）的分类在预测患者预后和确定治疗策略方面起着关键作用。共识分子亚型（CMS）分类系统是通过分析来自18个CRC数据集（包含4151个CRC样本）的基因信息构建而成的。CRC被分为具有不同分子和生物学特征的四个亚型：CMS1（微卫星不稳定免疫型）、CMS2（经典型）、CMS3（代谢型）和CMS4（间充质型）。自2015年命名以来，这些分类已应用于CRC的基础研究和转化研究，希望了解这些亚组将影响临床医生的治疗方法并改善临床结果。我们回顾了过去5年发表的符合CMSs的CRC研究，以进一步探索这些亚型的临床意义，并确定可能指导未来相关研究的潜在趋势。我们确定，CMSs在各种研究中关联了CRC细胞系和PDX模型的共同特征。此外，预后与临床病理结果之间的关联，包括病理分级、致癌阶段、肿瘤芽生和肿瘤位置，都与CMS分类相关。我们通过研究汇编确定了新的预后因素，并加强了化疗耐药性与CMS之间的关系；因此，表明本综述为CRC的临床问题和治疗策略提供了深入见解。
